There are many ways to lose weight and/or live a healthier lifestyle, and with the introduction of GLP-1 Agonist pharmacological approaches, there are even more to consider. As a dietitian, I often tell my patients that there is no one-size-fits-all approach. A pharmacological option may be something you and your physician consider. Or, you may want to change your diet. The third option may be to do both.
Drugs vs diet
The latest pharmacological approaches to weight loss are called GLP-1 agonists. These medications were developed for individuals with diabetes but are now being utilized (many of them "off-label") for their impact on weight loss, with one getting FDA approval for weight-loss. The mechanism of the medications is that they suppress appetite, slow the rate at which the stomach empties, and control blood sugar. The most common side effects of the medication can include nausea, diarrhea, vomiting, extreme difficulty eating and constipation. The alternative to the pharmacological approach is a dietary approach. Dietary patterns incorporating low and moderate carbohydrate approaches appear effective for individuals seeking blood sugar control and weight loss without pharmacological side effects. Here's how to structure it.
Moderate your carbohydrates
The benefits seen in some of the new drugs related to weight loss include a reduction of appetite and better blood sugar control. Both may occur when modifying carbohydrates to 130g or less daily (considered a moderate carbohydrate approach). A 2017 randomized control trial found low carbohydrate approaches were more effective than low-fat diets in increasing hormones associated with satiety. Additionally, lower-carbohydrate strategies are effective in the management of diabetes and weight loss as well. In a sense, this dietary pattern may provide many of the benefits seen in the pharmacological approaches popular in weight loss today without the addition of extreme restriction. Look at your dietary pattern and find your carbohydrate sources, then assess where you can find healthy reductions. For example, if you are used to eating pretzels for a snack, consider swapping for almonds. If your go-to breakfast is a pastry, consider switching to plain Greek yogurt with berries. If your lunch is typically a sandwich, consider swapping the bun for a cauliflower bun or low-carb tortilla. Instead of a pasta dish at dinner, think wild salmon and a side of quinoa and broccoli.
Fall in love with fiber.
There's a reason why it's easy to stop eating a large salad, but you may find it challenging to stop eating a bag of licorice. That reason may be fiber. Fiber is non-digestible to the body, meaning it takes some time to figure out what to do with it, so moving it through the system takes longer. This delayed digestion may help in creating fullness. Studies also suggest that specific components found in fiber can also help with fullness. High-fiber foods that may still fit well with a moderate to low carbohydrate approach include nuts and seeds, cruciferous vegetables, and small amounts of intact whole grains. Fiber is also associated with a better microbiome, which may help prevent chronic conditions and better weight management.
Prop up the protein.
Like fats and fiber, protein is satiating. A meta-analysis found that protein intake creates fullness. Therefore, besides following a moderate to lower carbohydrate approach to lose weight, adding moderate protein may also assist. In addition to fullness, adequate protein has also been associated with healthier eating overall and maintenance of muscle mass as we age. Great protein sources include skinless poultry, fatty wild fish, nuts and seeds, and full-fat dairy.
Finally, regardless of what you do, focus on health, not weight. With all the focus on getting thin quickly, it can be easy to forget what's important - health. Physical and mental health are the key factors to living longer and better. Being thin is not an automatic testament to being healthy. Prioritize numbers, like blood sugar, cholesterol, and liver enzymes, over the number on the scale.